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62
IV.—TUBERCULOSIS.
The result of the year's work in connection with tuberculosis must be regarded
as very satisfactory. There was a marked decrease in the number of notifications,
especially in respect of pulmonary tuberculosis in males. The case rate for all forms
of tuberculosis fell from 1.53 in 1935 to 1.36 in 1936, and a noteworthy feature was
the decline in the incidence of non-pulmonary tuberculosis from 0.31 in 1935 to 0.24
in 1936. The death rates give information which is more reliable and it will be noted
from the tables that the death rate for all forms of tuberculosis has been approximately
halved in the last ten years. This marked reduction in the rate for an industrial area
like Shoreditch is a matter of considerable satisfaction. The death rate from all
forms of tuberculosis for 1936 is 0.71 per 1,000 of the population. This rate is
considerably lower than that for London as a whole, though still slightly in excess of
that for England and Wales. The deaths for the pulmonary type of the disease also
showed a considerable decrease, viz., 0.72 in 1935 to 0.58 in 1936.
The decrease in the incidence of all forms of tuberculosis is apt to obscure the
fact that the non-pulmonary form of the disease is still a cause of much long-standing
illness, of crippling, and of many deaths. During the year 1936, 20 notifications of
non-pulmonary tuberculosis were received, and in addition another 13 cases came to
the notice of the medical officer of health other than by formal notifications. This
disease caused the death of 11 persons during the year.
Another regrettable feature of the trend of tuberculosis at the present time is
the high incidence of the disease among young adults. During the year 1936 the
number of cases of tuberculosis between the ages of 15 and 25 years which came to the
notice of the medical officer of health was as follows:—males 14, females 18. The
total number of new cases for the year was 87 males and 74 females, so that 19.9 per
cent. of the new cases occurred in persons between the ages of 15 and 25 years. I
have in previous reports referred to the grave problem created by this high incidence
of the disease in young adults and especially in young adult females in the country as
a whole.